Kourtney Renee Smith, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

295341 Issued in CA

Practice address

9045 US Highway 31
Berrien Springs, MI 49103-1804

Phone

(269) 471-7621

NPI assigned

Mar 12, 2019

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals (MDPP)

  • Community Health Clinic/Center
  • Saint Joseph, MI
  • NPI 1184513731
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1174081871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031804",
            "telephone_number": "269-861-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031804",
            "telephone_number": "269-471-7621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Longmeadow Village Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491207810",
            "country_code": "US",
            "telephone_number": "269-687-0945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KOURTNEY",
        "middle_name": "RENEE",
        "credential": "DPT, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lars Sherburn
• Jane Anne Sherwin, RN
• Crystal Smeal
• Chana Ione Smith, PT
• Harold B Smith, PYS.D.
• Sarah K. Smith, LMT
• Chloe M Son, D.M.D.
• Linda Song, NP-C
• Southwestern Medical Clinic Oc
• Spinalhealth & Healing

• Physical Therapist in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.